Liver disease
Liver disease | |
---|---|
Other names | Hepatic disease |
liver metastases caused by pancreatic cancer | |
Specialty | Hepatology, gastroenterology |
Types | Fatty liver disease, Hepatitis (and several more)[1] |
Diagnostic method | Liver function tests[2] |
Treatment | Depends on type(See types) |
Liver disease, or hepatic disease, is any of many diseases of the liver.[1] If long-lasting it is termed chronic liver disease.[3] Although the diseases differ in detail, liver diseases often have features in common.
Liver diseases
-
Ground glass hepatocytes
-
Primary biliary cirrhosis
-
Budd–Chiari syndrome
-
non-alcoholic fatty liver disease
There are more than a hundred different liver diseases. Some of the most common are:[4]
- Fascioliasis, a parasitic infection of liver caused by a liver fluke of the genus Fasciola, mostly Fasciola hepatica.[5]
- Hepatitis, inflammation of the liver, is caused by various viruses (viral hepatitis) also by some liver toxins (e.g. alcoholic hepatitis), autoimmunity (autoimmune hepatitis) or hereditary conditions.[6]
- Non-alcoholic fatty liver disease is a spectrum of disease associated with obesity and metabolic syndrome.[9]
- In transthyretin-related hereditary amyloidosis, the liver produces a mutated transthyretin protein which has severe neurodegenerative or cardiopathic effects. Liver transplantation can be curative.[13]
- Gilbert's syndrome, a genetic disorder of bilirubin metabolism found in a small percent of the population, can cause mild jaundice.[14]
- Cirrhosis is the formation of fibrous tissue (fibrosis) in the place of liver cells that have died due to a variety of causes, including viral hepatitis, alcohol overconsumption, and other forms of liver toxicity. Cirrhosis causes chronic liver failure.[15]
- Primary liver cancer most commonly manifests as hepatocellular carcinoma or cholangiocarcinoma; rarer forms include angiosarcoma and hemangiosarcoma of the liver. (Many liver malignancies are secondary lesions that have metastasized from primary cancers in the gastrointestinal tract and other organs, such as the kidneys, lungs.)[16]
- autoimmune disease of the bile capillaries.[17]
- Primary sclerosing cholangitis is a serious chronic inflammatory disease of the bile duct, which is believed to be autoimmune in origin.[18]
- hepatic vein.[19]
Signs and symptoms
Some of the signs and symptoms of a liver disease are the following:
- Jaundice[20]
- Confusion and altered consciousness caused by hepatic encephalopathy.[21]
- Thrombocytopenia and coagulopathy.[22]
- Risk of bleeding symptoms, particularly taking place in the gastrointestinal tract[23]
Mechanisms
Liver diseases can develop through several mechanisms:
DNA damage
One general mechanism, increased
Viral infection by hepatitis B virus, or hepatitis C virus causes an increase of
Alcohol consumption in excess causes a build-up of acetaldehyde. Acetaldehyde and free radicals generated by metabolizing alcohol induce DNA damage and oxidative stress.[31][32][33] In addition, activation of neutrophils in alcoholic liver disease contributes to the pathogenesis of hepatocellular damage by releasing reactive oxygen species (which can damage DNA).[34] The level of oxidative stress and acetaldehyde-induced DNA adducts due to alcohol consumption does not appear sufficient to cause increased mutagenesis.[34] However, as reviewed by Nishida et al.,[28] alcohol exposure, causing oxidative DNA damage (which is repairable), can result in epigenetic alterations at the sites of DNA repair. Alcohol-induced epigenetic alterations of gene expression appear to lead to liver injury and ultimately carcinoma.[35]
Obesity is associated with a higher risk of primary liver cancer.[36] As shown with mice, obese mice are prone to liver cancer, likely due to two factors. Obese mice have increased pro-inflammatory cytokines. Obese mice also have higher levels of deoxycholic acid, a product of bile acid alteration by certain gut microbes, and these microbes are increased with obesity. The excess deoxycholic acid causes DNA damage and inflammation in the liver, which, in turn, can lead to liver cancer.[37]
Other relevant aspects
Several liver diseases are due to viral infection.
Air pollutants
Particulate matter or carbon black are common pollutants. They have a direct toxic effect on the liver; cause inflammation of liver caused by and thereby impact lipid metabolism and fatty liver disease; and can translocate from the lungs to the liver.[46]
Because particulate matter and carbon black are very diverse and each has different toxicodynamics, detailed mechanisms of translocation are not clear. Water-soluble fractions of particulate matter are the most important part of translocation to the liver, through extrapulmonary circulation. When particulate matter gets into the bloodstream, it combines with immune cells and stimulates innate immune responses.
Diagnosis
A number of
Imaging tests such as
In liver disease,
A previously undiagnosed liver disease may become evident first after autopsy.[citation needed] Following are gross pathology images:
-
Diffuse cirrhosis
-
Macronodular cirrhosis
-
Nutmeg texture of congestive hepatopathy
Treatment
Anti-viral medications are available to treat infections such as hepatitis B.[49] Other conditions may be managed by slowing down disease progression, for example:
- By using steroid-based drugs in autoimmune hepatitis.[50]
- Regularly removing a quantity of blood from a vein (venesection) in the iron overload condition, hemochromatosis.[51]
- Wilson's disease, a condition where copper builds up in the body, can be managed with drugs that bind copper, allowing it to be passed from the body in urine.[52]
- In cholestatic liver disease, (where the flow of bile is affected due to cystic fibrosis[53]) a medication called ursodeoxycholic acid may be given.[54]
See also
- Model for end-stage liver disease(MELD)
References
- ^ a b "Liver Diseases". MedlinePlus.
- ^ a b MedlinePlus Encyclopedia: Liver function tests
- ^ "NHS Choices". Cirrhosis. Retrieved 6 October 2015.
- ^ "Liver disease – NHS Choices". www.nhs.uk. Retrieved 2015-06-20.
- ^ "CDC – Fasciola". www.cdc.gov. Retrieved 2015-06-20.
- ^ "Hepatitis". MedlinePlus.
- ^ MedlinePlus Encyclopedia: Alcoholic liver disease
- ^ "Hepatic steatosis". Retrieved 2015-06-20.
- ^ "Non-alcoholic fatty liver disease – NHS Choices". www.nhs.uk. Retrieved 2015-06-20.
- ^ "Hemochromatosis". MedlinePlus.
- ^ "Alpha-1 Antitrypsin Deficiency". MedlinePlus.
- PMID 20301438.
- ^ "Transthyretin amyloidosis". Genetics Home Reference. Retrieved 2015-06-20.
- ^ "Gilbert syndrome". Genetics Home Reference. Retrieved 2015-06-20.
- ^ "Cirrhosis: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-06-20.
- ^ "Liver cancer – Hepatocellular carcinoma: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-06-20.
- ^ "Primary biliary cirrhosis: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-06-20.
- ^ "Sclerosing cholangitis: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-06-20.
- ^ "Hepatic vein obstruction (Budd-Chiari): MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-06-20.
- ^ "Liver Disease | NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 2021-11-30.
- ^ "Alcoholic Liver Disease". The Lecturio Medical Concept Library. Retrieved 27 June 2021.
- ^ S2CID 23396752.
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- ^ "Chronic Liver Disease/Cirrhosis | Johns Hopkins Medicine Health Library". 12 April 2022.
- ^ PMID 28487602.
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- ^ PMID 24281019.
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- ^ "Drinking alcohol causes cancer by 'damaging DNA' - Independent.ie". 5 January 2018.
- ^ PMID 22524187.
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- )
- ^ "Gut Bugs Could Explain Obesity-Cancer Link | Science | AAAS". 2013-06-26.
- PMID 24928290.
- PMID 25083074.)
{{cite journal}}
: CS1 maint: DOI inactive as of January 2024 (link - ^ "Hepatitis B and C: ways to promote and offer testing to people at increased risk of infection | Guidance and guidelines | NICE". www.nice.org.uk. 12 December 2012. Retrieved 2015-06-24.
- PMID 22232374.
- PMID 25278689.
- ^ PMID 25278688.
- PMID 27802157.
- PMID 33807722.
- ^ PMID 25071914.
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- ^ S2CID 11457839.
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- ISBN 9781607615699.
- ^ "Phlebotomy Treatment | Treatment and Management | Training & Education | Hemochromatosis (Iron Storage Disease) | NCBDDD | CDC". www.cdc.gov. Retrieved 2015-06-20.
- ^ "Wilson Disease". www.niddk.nih.gov. Archived from the original on 2015-06-21. Retrieved 2015-06-20.
- ISBN 9781107729094.
- PMID 28891588. Retrieved 2015-06-20.
Further reading
- Friedman, Lawrence S.; Keeffe, Emmet B. (2011-08-03). Handbook of Liver Disease. Elsevier Health Sciences. ISBN 978-1455723164.